Arthritis and Employment

Justin Tomlinson Excerpts

Tuesday 21st May 2019 Westminster Hall

[Douglas Ross (Moray) (Con)]

It is a pleasure to serve under your chairmanship, Sir Graham. I congratulate my hon. Friend the Member for Ayr, Carrick and Cumnock (Bill Grant) on securing this debate and on his outstanding speech, which showed his passion and enthusiasm for this topic. I listened carefully, and I do not think he declared an interest at the start, so the spring in his step that we see from him every day around Westminster is perfectly natural and his interest in this debate comes not from any self-interest, but is for his constituents, who have rightly raised the issue. It was good to hear what he has done in his office to accommodate a member of staff.

I want to briefly give some figures from my constituency of Moray. Nationally, 63% of people of working age who have arthritis are in work. When we look at the figures more closely, in Moray, people over 45 with osteo- arthritis of the hip number 4,757. There are 7,848 people over 45 with osteoarthritis of the knee. There are 653 people with rheumatoid arthritis. There are 15,526 people in Moray with back pain. Had it not been for my hon. Friend’s debate today, I would not have known that such a large number of people within my community suffer day in, day out with this condition.

We heard from the hon. Member for North Tyneside (Mary Glindon) about a young person who lives with arthritis. It is testament to them that much of the time when we see them in our communities, they put on a very brave face. They work hard to live with their condition while in excruciating pain. This debate has shown that there is support for them, and we have to do all we can to encourage them to take up that offer of support, but we should also realise how many of those we work with day in, day out in our communities suffer from arthritis.

Arthritis and related conditions are the biggest cause of pain and disability in the United Kingdom, and account for 28.2 million working days lost each year. Nearly half of all work-related illnesses in Scotland are related to arthritis and joint pain, so it is a considerable issue, both in Scotland and across the United Kingdom, and something that we really need to tackle.

I welcome the presence of the Minister, who I am sure will speak about the Access to Work scheme. It is an excellent scheme that we should promote, but as my hon. Friend the Member for Ayr, Carrick and Cumnock said, we need to promote it because there is not enough awareness of its benefits. As he said, between May and June 2018 Versus Arthritis surveyed 15,082 people with arthritis and related conditions. Those people live with it, day in, day out, and are acutely aware of the need for assistance and support. Yet almost 60%—59%—had never heard of the scheme, so the people we are trying to target are unaware of a scheme that is designed to help them.

Worryingly—I would appreciate the Minister’s response to this, if he is aware of why it has happened—the number of people with arthritis who benefit from the scheme has fallen each year.

[The Minister for Disabled People, Health and Work (Justin Tomlinson)]

indicated dissent.

[Douglas Ross]

That was from a briefing that I received ahead of the debate. If the Minister does not believe that to be the case, it would be useful to clarify that on the record. Certainly the campaign group supporting the debate and briefing MPs says that it has fallen, year on year, over the last five years. I welcome any update from the Minister on that.

I welcome the debate, which is an opportunity for us all to raise awareness of this crippling condition, to support those in our communities who live with arthritis, and to try to get them better services to allow them to work. They all want to be part of the community, and part of the working community. We can support them as a Government and as MPs. Today, because of my hon. Friend the Member for Ayr, Carrick and Cumnock, we have done that.

--- Later in debate ---

[Mike Amesbury (Weaver Vale) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Graham. I thank the hon. Member for Ayr, Carrick and Cumnock (Bill Grant) for securing such a vital debate, which has been informed by a number of charities, which work so hard for the benefit of people with disabilities and those who suffer with arthritis and related conditions.

As we have heard through the very powerful contributions from the 13 Members present from across the House, living with the condition can be debilitating and have a negative impact on quality of life. Arthritis and related conditions are the biggest cause of pain and disability in the UK. As a result, 28.2 million working days are lost annually. Every year, one in five people—20% of the UK population—consults a GP about musculoskeletal problems. More than half of the 17.8 million people in the UK with arthritis and related conditions live with pain every single day. My hon. Friend the Member for North Tyneside (Mary Glindon) highlighted that with the stark case of Danielle. Her condition has a huge impact on her life, slowly intrudes on everyday life, and affects her ability to work, to sustain work and to live independently.

Arthritis can also have a huge impact on an individual’s mental health, as hon. Members have highlighted. Living with a painful condition can lead to depression and anxiety, as well as placing limits on a person’s ability to keep active and to stay connected within communities and society.

We should pay particular attention to the disturbing fact that people in the most deprived areas of the UK are much more likely to report arthritis or back pain than people in equivalent age groups who live in less deprived areas. Some 40% of men and 44% of women in the poorest households report chronic pain, compared with 24% of men and 30% of women in more affluent households. There is a real social class and inequality issue here.

Versus Arthritis, the charity whose excellent work is dedicated to changing the lives of people who live with arthritis and related conditions, estimates that 10% of the UK population aged over 45 suffer with osteoarthritis of the hip, 17% suffer with back pain and 18% suffer with osteoarthritis of the knee. Many Members have highlighted the higher prevalence in their constituencies, which is also the case in mine.

This Government’s apparent antipathy and lack of regard for those who suffer with arthritis and related illnesses has been demonstrated in their limited approach to the promotion of the Access to Work scheme, which has been highlighted by Members across the House. The charity Leonard Cheshire has argued that there has been no significant extension of the programme over the last nine years.

[Justin Tomlinson]

indicated dissent.

[Mike Amesbury]

The Minister shakes his head, but that is from the Government’s own figures.

Will the Minister tell the House what plans are in place to help people with musculoskeletal conditions in the workplace? Arthritis sufferers who have applied to the Government’s Access to Work scheme said they have faced problems with how the scheme operates. In a survey of people with arthritis and related conditions carried out by Versus Arthritis in 2018, 59% had never heard of the Access to Work scheme, with many more unaware of what help was available. It is almost the best kept secret, as my hon. Friend the Member for Ellesmere Port and Neston (Justin Madders) said.

Some 25% of respondents said they did not receive all the support that was asked for, or that had been recommended by the Access to Work adviser, with a further 10% saying they did not receive any support whatsoever after applying. Will the Minister tell the House what the Government are doing to ensure that recommendations made by the Access to Work scheme are enacted?

The Equality Act 2010 placed a legal responsibility on employers to provide reasonable adjustments to support people with a disability in the workplace, so that they would not be disadvantaged. However, the Equality Act does not define what those reasonable adjustments are. As a result, it can be difficult for someone with arthritis to know exactly what their employer should be doing to help them, especially if they are not unionised, as was pointed out. Will the Minister tell the House whether the Government plan to undertake work to clarify the meaning of “reasonable adjustments”? Would he agree to work with Versus Arthritis on that?

One in eight of the working-age population has a musculoskeletal problem, but only 63% of that group are in work, compared with 81% of people with no health condition. What steps are the Government taking to close the disability employment gap for people with arthritis and related illnesses?

The Government have pledged to see 1 million more people with disabilities and long-term health conditions in work by 2027—just 100,000 people per year. Curiously, the Office for National Statistics reports that the increased number of disabled people in work has not been matched by a reduction in the number of disabled people who are out of work. We are now two years into the Government’s 10-year strategy for supporting disabled people into work. However, the National Audit Office reports that they have yet to develop a full implementation plan to achieve their goal.

Through whatever kaleidoscope of smoke and mirrors we look when measuring our employment figures, facts are facts: the disability employment gap remains stubbornly at 30% and this Government are failing to get a grip on that dismal statistic. I ask the Minister to listen to the concerns raised by all the Members here today and to commit to addressing and rectifying the unacceptable existing inequality of support for those who suffer with arthritis.

[The Minister for Disabled People, Health and Work (Justin Tomlinson)]

It is a pleasure to serve under your chairmanship, Sir Graham. I pay tribute to all the speakers—perhaps with the exception of the last one—for their very proactive and constructive speeches on this incredibly important subject. It reflects well on the brilliant opening speech given by my hon. Friend the Member for Ayr, Carrick and Cumnock (Bill Grant), who demonstrated a real passion, knowledge and interest in this area, that it was picked up and reflected in each and every speech. People who have listened to the debate will be encouraged at the great level of interest—it is not as if nothing else is happening in Parliament today. It is brilliant that this issue has captured so much interest.

My hon. Friend was spot on when he quoted Dame Carol Black, who said:

“The evidence is clear that most people with these disabling conditions want to work. Indeed, with the right support and working arrangements, usually with modest adjustments, they can do so and be valued employees.”

He made the powerful point that there is a misconception that this impacts only on older people. In fact, it can affect people throughout their lives. One in six people will develop a disability or long-term health condition, and many of them will be of working age. This is a common challenge and barrier that people need to overcome. I welcome the hon. Member for Newport West (Ruth Jones)—with her expertise in this area, I am sure that she will be a valuable addition to Parliament.

Despite the previous, pre-written speech, the reality of the disability stats is that there are now 947,000 more disabled people in work in the past five years. We have taken disability employment from 44.2% to 51.7%, which is a record high. For the first time, more disabled people are in work than not. However, it is not enough. We are an ambitious Government, and we set out two years ago our ambition for a further 1 million disabled people to be in work. In those first two years, over 400,000 more disabled people are in work. We are ahead of schedule, but it is still not enough.

We will continue to do everything we can to empower businesses to have the confidence to tackle the barriers and take advantage of the huge amount of talent that is all too often overlooked. I do not just preach as a Minister; I say that as an employer. Before I became an MP, my own business benefited from employing disabled people and having the confidence to make small changes. Actually, I benefited. I have been in a series of stakeholder meetings and events today, and everyone was united in saying we have to ensure it works for everyone.

The majority of today’s speeches focused on Access to Work, and I recognise that it is right to challenge the scheme. However, we must recognise that 33,800 people were helped last year—up 13%, and a record high. My hon. Friend the Member for Moray (Douglas Ross) asked whether funding had been increased or decreased in this area. We do not record that specifically, but people who listed conditions that relate to the arms and hands, legs and feet or back and neck—we would expect those to be covered predominantly in this area—as their primary medical condition accounted for about 10% of our spend, which was up 2% on last year.

I recognise hon. Members’ broad point that more people need to benefit from the Access to Work scheme, especially in this area—particularly as technology plays an increasing part in removing barriers and creating opportunities, which I have seen on visits. The hon. Member for Lanark and Hamilton East (Angela Crawley) discussed her caseworker and explained how she is benefiting from small changes that can be replicated right across the board.

The key is improving the awareness of Access to Work. We are looking at improving awareness in jobcentres, so that in the initial conversation we take into account everybody’s unique opportunities and challenges, particularly on health, and that it is ingrained in all our frontline staff that this is an option to help unlock barriers. That goes right to the core of the principle of the joint work and health unit. I had a meeting about that earlier, and we recognise just how important it is. We need to work more closely with stakeholders to promote this to their members as something that can be utilised. We should work with GPs and health professionals to ensure that they are aware of the opportunity.

On fit notes, GPs can highlight the fact that there are fluctuating health conditions that can limit the amount of work someone can do. I understand the point that was made, and we are working with medical professionals to look at what more can be done in that area. We need to look at our health and work providers and ensure they include it—it should be embedded in their options. Through the Disability Confident scheme, we are now at 12,000 businesses—a record high. We have ambitions to increase that rapidly and are looking at putting additional requirements on the highest level of Disability Confident. We should perhaps look at signposting from general benefits. If we have identified people with health conditions through disability benefits, we could perhaps signpost people for additional local support. It is not something that they must have, but providing such information could be helpful for people.

There is one area where I think we can make a real difference. The hon. Member for Ellesmere Port and Neston (Justin Madders) made a really good point: how can we be sure that businesses have an understanding? For many, particularly small and medium-sized businesses, this is not necessarily a common occurrence, and they like to have confidence. There is an opportunity through the Health and Safety Executive. It is a pretty good given. As part of the Health and Safety Executive, we lead internationally on safety. We have just recruited a new chief executive, and I made it very clear to her that the real priority going forward has to be looking at health. The HSE is brilliant at engaging with businesses of all sizes as part of those assessments, and they can identify areas of improvement within working environments. A one-stop shop can be a portal to signpost additional support, particularly on not letting people slip out of work. It is a darn sight harder to get people back into work than it is to keep them in work in the first place.

I was very interested to talk to my Access to Work team about ways in which we can help. Initially, I thought it was perhaps simply about technology. I was looking at some case studies—we cannot give names, for obvious reasons—and in some cases it is about technology. It is sometimes about making adjustments to the equipment that people use. Access to Work will talk to an employer and perhaps suggest changing the working hours or recognising that there might be times when they will have to limit them. Perhaps they could even look at changing people’s roles, which is incredibly important. If someone works for a big employer that has HR and personnel teams, we would expect them as a given to get this right. However, 40% of private sector jobs are in small and medium-sized businesses. They do not necessarily have bad intentions, but they do not have the confidence or expertise. Through organisations such as the HSE we can do a lot more.

I pay tribute to Versus Arthritis, with which I will definitely be working very closely. I will be speaking at its event in July. It is one of our key stakeholders in the Access to Work scheme, which goes through, line by line, how we are doing and what improvements we need to make. The Versus Arthritis report was very proactive and helpful.

I was genuinely impressed by how proactive and constructive the speeches we have heard were. There is a real cross-party commitment to get this right—it is such an important issue. Not everybody is looking for a full-time job or career. I have met young disabled people for whom simply being able to do one hour is a life-changing opportunity. Wherever there is a barrier, we as a Government are absolutely committed to remove it. We want businesses to have the confidence to take advantage of the huge amount of talent that, I am afraid, is all too often overlooked. We are heading in the right direction, but we are ambitious to do more. I thank each and every hon. Member for what they are doing to highlight all the opportunities that people can take advantage of.